Abstract
Background
Among patients who underwent dual chamber devices (DDD) implantation, new occurrence of atrial fibrillation (AF) is higher compared to general population. However, it is unclear which factors affect new onset AF. Previous studies reported that the prolonged P wave dispersion (PWD) in sinus rhythm could be considered as an index for progression of conduction disturbance as the arrhythmogenic state for AF. In this study, we sought to elucidate the clinical factors including PWD associated with silent atrial high rate episode (AHRE) in the population of DDD.
Methods
The study population consisted of 101 patients with DDD from 2010 to 2014. All patients were measured PWD at the time of implantation. AHRE was defined as any episode of sustained atrial tachyarrhythmia (>170 bpm). AHREs were evaluated during initial 1 year after the implantation. They were divided into AHRE group (n=34) and non-AHRE group (n=67) and various clinical parameters were compared.
Results
The mean age was 75±11 years old. The AHRE groups showed higher rate of diagnosis of sick sinus syndrome (p=0.05) and longer PWD (62.6±13.1 versus 38.2±13.9 ms, p<0.0001) in comparison with non-AHRE group. Multivariate analysis revealed that the PWD was significant independent factors for the prediction of new appearance of AHRE (OR: 1.12; 95% CI, 1.07–1.17; p<0.0001). Cut-off value for parameter was determined by ROC curves achieving highest sensitivity and specificity, 48 mm was the best point of PWD (sensitivity of 73.8%, specificity of 77.9%, AUC 0.78).
ROC curve
Conclusion
PWD were significant predictor for new appearance of AHRE in patients with DDD.
Dual chamber versus single chamber ventricular pacemakers for sick sinus syndrome and atrioventricular block